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Community Care Systems, Inc.

Organization Active NPI In Home Supportive Care Agency · Pittsfield, IL

NPI 1184036253 · NPPES record last updated Oct 26, 2016

Key facts

NPI
1184036253
Entity type
Organization (NPI type 2)
Primary specialty
In Home Supportive Care Agency 253Z00000X
Legal business name
COMMUNITY CARE SYSTEMS, INC.
Practice address
115 West Madison St
Pittsfield, IL 62363-1405
Phone
(217) 285-5413
Fax
(217) 285-4602
NPI assigned
May 23, 2014
Organization subpart
No

Authorized official

Name
Mr. Frank J Vala
Title
Ceo
Phone
(217) 698-0200

Corporate family (same tax ID) 13

Organizations that report the same tax identification number in the National Provider Directory.

National Provider Directory

Tax ID family
Community Care Systems Inc (14 organizations share this tax ID)

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
In Home Supportive Care Agency 253Z00000X Yes

Addresses

Primary practice location

115 West Madison St
Pittsfield, IL 62363-1405

Mailing address

405 N Macarthur Blvd
Springfield, IL 62702-2312
Phone (217) 698-0200

Other identifiers

IdentifierTypeStateIssuer
923MedicaidIL

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Oct 26, 2016.

{
    "created_epoch": "1400803200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1477440000000",
    "number": "1184036253",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "405 N MACARTHUR BLVD",
            "city": "SPRINGFIELD",
            "state": "IL",
            "postal_code": "627022312",
            "telephone_number": "217-698-0200",
            "fax_number": "217-698-9862"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "115 WEST MADISON ST",
            "city": "PITTSFIELD",
            "state": "IL",
            "postal_code": "623631405",
            "telephone_number": "217-285-5413",
            "fax_number": "217-285-4602"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMMUNITY CARE SYSTEMS, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-05-23",
        "last_updated": "2016-10-26",
        "status": "A",
        "authorized_official_last_name": "VALA",
        "authorized_official_first_name": "FRANK",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "217-698-0200",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "923",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Pittsfield, IL

All providers in Pittsfield, IL · In Home Supportive Care Agency in Illinois

Sources for this page

Verify at the official NPI Registry.